Use Case Diagram

10.1.4 TB Diagnosis - Events
Use Case Diagram Health Service Event #1 – Patient assessment Event Diagram

Actors

Patient
Physician
Clinic’s EMR system (POS)
EHRi systems

Assumptions

There are two involved jurisdictions (e.g. the jurisdiction where the patient lives and the jurisdiction where the patient going to university and the visit takes place); also, there is two (minimum) EHR.
The patient is already registered in the clinic’s ADT system.
The clinic’s ADT system is interfaced with the clinic’s EMR system. So, when a patient is created/updated in the clinic’s ADT system, the patient index is automatically updated in the clinic’s EMR system.
The physician is already logged on the clinic’s EMR system.
To resolve the patient’s identification, the provincial health care number is also used, because it is key information to find the patient. In this case, the physician uses the following key information to find the patient: name, birth date, and provincial health care number.
The resolution of the patient’s identification information is also necessary to obtain a “temporary” unique patient identifier from the EHR, to allow the user to view and update the patient’s record. The “temporary” unique patient identifier (EHRi Transaction Client ID) is provided by the EHRi only for one user session (without a break in the time), for the same patient and the same provider (person) who are engaged in the health service event. If there is an interruption during a health service, this becomes another health service event, and another resolution of the patient’s identification is required to obtain another “temporary” unique patient identifier (EHRi Transaction Client ID).
The “health profile” is an organized collection of specific events, whose definition depends on practices of each organization and jurisdiction. In this case, two jurisdictions are involved but the physician wants to see the “health profile” for the current jurisdiction.

Workflow Event Step	POS Action	EHRi System Action	EHR IP reference
The physician measures the induration and determines the test is positive. He is concerned that this might be active TB infection.
To try to clarify this, the physician accesses to patient record.
Resolution of patient’s identification (in the current jurisdiction)
The physician enters the patient’s identification information in the clinic’s EMR system.	The POS EMR system searches locally and finds the patient. The POS EMR system sends, to the EHRi system, a request with the key information (ex. name, birth date, provincial health care number) (and to obtain a EHRi Transaction Client ID).	The EHRi system searches and finds for the client in the current jurisdiction, with the provided key information (ex. name, birth date, provincial health care number).	EHRIP10 Search Patient
		The EHRi System Client Registry returns, to POS system, the corresponding patient record (with a EHRi Transaction Client ID).
	The POS EMR system displays the corresponding record of current patient.
Consultation of the patient’s health profile (for the current jurisdiction)
The physician does a request through his clinic’s EMR system to review the patient’s health profile.	The POS EMR system sends, to the EHRi system, a search request to obtain the patient’s health profile for the current patient (for the EHRi Transaction Client ID) and jurisdiction.	The EHRi system searches and finds (in current jurisdiction) the information of health profile for the current patient (for the EHRi Transaction Client ID).	EHRIP09 Get Patient Health Profile
		The EHRi system returns, to POS system, the health profile for the current patient.
	The POS EMR system receives, organizes and displays the patient’s health profile.
The physician views the patient’s health profile: - Allergies, - Medications, - Past medical history, - Immunizations. The physician finds no record of BCG vaccination or prior TB infection.
The physician decides to treat this as an active infection, so he prescribes the appropriate antibiotics.

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General Info
Name	Health Service Event #1 – Patient assessment Event Diagram
Type	Use Case Diagram